ADOLESCENTS AND ALCOHOL

Adolescent intermittent ethanol (AIE) produces lasting, sex-specific changes in rat body fat independent of changes in white blood cell composition

Early initiation of alcohol use during adolescence, and adolescent binge drinking are risk factors for the development of alcohol use disorder later in life. Adolescence is a time of rapid sex-dependent neural, physiological, and behavioral changes as well as a period of heightened vulnerability to many effects of alcohol. The goal of the present studies was to determine age-related changes in blood (leukocyte populations) and body composition across adolescence and early adulthood, and to investigate whether adolescent intermittent ethanol (AIE) exposure would alter the trajectory of adolescent development on these broad physiological parameters. We observed significant ontogenetic changes in leukocyte populations that were mirrored by an age-related increase in cytokine expression among mixed populations of circulating leukocytes. Despite these developmental changes, AIE did not significantly alter overall leukocyte numbers or cytokine gene expression. However, AIE led to sex-specific changes in body fat mass and fat percentage, with AIE-exposed male rats showing significantly decreased fat levels and female rats showing significantly increased fat levels relative to controls. These changes suggest that while AIE may not alter overall leukocyte levels, more complex phenotypic changes in leukocyte populations could underlie previously reported differences in cytokine expression. Coupled with long-term shifts in adipocyte levels, this could have long-lasting effects on innate immunity and the capacity of individuals to respond to later immunological and physiological threats.

Consequences of adolescent drug use

Substance use in adolescence is a known risk factor for the development of neuropsychiatric and substance use disorders in adulthood. This is in part due to the fact that critical aspects of brain development occur during adolescence, which can be altered by drug use. Despite concerted efforts to educate youth about the potential negative consequences of substance use, initiation remains common amongst adolescents world-wide. Additionally, though there has been substantial research on the topic, many questions remain about the predictors and the consequences of adolescent drug use. In the following review, we will highlight some of the most recent literature on the neurobiological and behavioral effects of adolescent drug use in rodents, non-human primates, and humans, with a specific focus on alcohol, cannabis, nicotine, and the interactions between these substances. Overall, consumption of these substances during adolescence can produce long-lasting changes across a variety of structures and networks which can have enduring effects on behavior, emotion, and cognition.

Alcohol binge drinking in adolescence and psychological profile: Can the preclinical model crack the chicken-or-egg question?

During adolescence, internal and external factors contribute to engaging with alcohol binge drinking (ABD), putting at risk the neurodevelopment of brain regions crucial for emotional control and stress coping. This research assessed the prevalence of ABD in late adolescent students of Southern Italy and characterized their psychological profile and drinking motives. Translational effects of alcohol binge drinking in the animal model were also studied. Seven hundred and fifty-nine high school students of both sexes (aged 18-20) were recruited. Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), Drinking Motives Questionnaire-Revised Short Form, Millon Clinical Multiaxial Inventory-Third Ed., State-Trait Anxiety Inventory, Connor-Davidson Resilience Scale, and Basic Self-Esteem Scale identified alcohol habits, drinking motives, and psychopathological profile. Eighty-five percentage of the students drank alcohol and 28% of them engaged in ABD; AUDIT-C correlated with enhancement, coping, and conformity motives. ABD was related to a greater likelihood of presenting clinical syndromes and personality disorders, as well as low resilience and self-esteem. Thereafter, in the pre-clinical model, adolescent male rats were exposed to alcohol (3.5 g/kg) in an intermittent binge-like paradigm and tested during prolonged abstinence. Rats were evaluated for anxiety-like behavior, motivated behaviors, resilience, and stress response following a psychosocial challenge. Binge-like alcohol-exposed adolescent rats displayed high integrated z-score for social- and novelty-induced anxiety, altered motivation-driven output, decreased resilience, and a blunted HPA axis response to psychosocial stress, with respect to respective controls. Our data confirm that ABD is the chosen pattern of drinking in a significant percentage of high school students in Southern Italy, and highlights AUDIT-C score as a relevant parameter able to predict the occurrence of affective disturbances. The evidence from the preclinical model shows that ABD produces detrimental consequences in the adolescent rat brain, resulting in negative affect, emotional dysregulation, and aberrant stress response, pointing to decreasing excessive alcohol drinking as a primary goal for the global act for brain health.

The Spiral of Positive Feedback: Go-Along Interviews About Adolescents’ Perceptions of and Reactions to Alcohol Posts on Social Media

Go-along interviews among adolescents ( N = 26, M age = 16.31, SD = .83) were conducted to examine how adolescents interpret alcohol posts in terms of appropriateness and how this, in turn, plays a role in adolescents’ reactions toward alcohol posts on public and private social media entries. The findings of this study, first, indicate that alcohol posts were classified as appropriate or inappropriate based on the amount of alcohol and the displayed behavior in the post. Second, most posts, including inappropriate ones, received positive or no feedback. Moreover, adolescents deliberately seemed to withhold negative feedback out of fear of being misjudged by peers. Still, negative reactions were expressed more quickly in safer off- and online environments (i.e., face-to-face conversation and online chat messages) because they were visible to close friends only. This is important in view of prevention as it unravels the interesting role of private environments in stimulating negative interpersonal communication.

Expression of Oligodendrocyte and Oligoprogenitor Cell Proteins in Frontal Cortical White and Gray Matter: Impact of Adolescent Development and Ethanol Exposure

Adolescent development of prefrontal cortex (PFC) parallels maturation of executive functions as well as increasing white matter and myelination. Studies using MRI and other methods find that PFC white matter increases across adolescence into adulthood in both humans and rodents. Adolescent binge drinking is common and has been found to alter adult behaviors and PFC functions. This study examines development of oligoprogenitor (OPC) and oligodendrocytes (OLs) in Wistar rats from adolescence to adulthood within PFC white matter, corpus callosum forceps minor (fmi), PFC gray matter, and the neurogenic subventricular zone (SVZ) using immunohistochemistry for marker proteins. In addition, the effects of adolescent intermittent ethanol exposure [AIE; 5.0 g/kg/day, intragastric, 2 days on/2 days off on postnatal day (P)25-54], which is a weekend binge drinking model, were determined. OPC markers NG2+, PDGFRα+ and Olig2+IHC were differentially impacted by both age and PFC region. In both fmi and SVZ, NG2+IHC cells declined from adolescence to adulthood with AIE increasing adult NG2+IHC cells and their association with microglial marker Iba1. PFC gray matter decline in NG2+IHC in adulthood was not altered by AIE. Both adult maturation and AIE impacted OL expression of PLP+, MBP+, MAG+, MOG+, CNPase+, Olig1+, and Olig2+IHC in all three PFC regions, but in region- and marker-specific patterns. These findings are consistent with PFC region-specific changes in OPC and OL markers from adolescence to adulthood as well as following AIE that could contribute to lasting changes in PFC function.

How adolescents' working memory abilities relate to their alcohol craving in real-life contexts depends on biological sex

AIM

We sought to elucidate whether stress, peers, and in vivo (i.e., direct) alcohol cues elicit alcohol craving in daily life among adolescents and to test whether individual variation in working memory function and biological sex alters these associations.

METHODS

We leveraged ecological momentary assessment (EMA) to examine momentary associations between stress, peers, and direct alcohol cues with craving, assessed as "urge to drink alcohol," among 86 male (51.2 %) and female (48.8 %) frequent drinkers (i.e., two or more drinking days per week). Participants were ages 14-24 years (M = 20.7 years, SD = 2.1). Participants completed EMA throughout the day for about one week prior to randomization to a treatment condition for an AUD clinical trial. Pre-registered, secondary analyses focused on craving for assessments when adolescents were not drinking, and assessments occurring after drinking on drinking days were removed. Working memory performance was assessed in the laboratory via the Memory for Words subtest of the Woodcock-Johnson III Tests of Cognitive Abilities.

RESULTS

Craving was heightened at more stressful moments and when adolescents were with their peers and in the presence of direct alcohol cues. Working memory function was not related to craving but altered the relation of momentary stress, peers, and cues with craving once biological sex-related differences were considered. Females generally had lower craving than males, but working memory function served to buffer against stress-induced craving for males.

CONCLUSIONS

Higher working memory function buffered the in-the-moment relation of stress with alcohol craving for males but not females.

Safe schools for teens: preventing sexual abuse of urban poor teens, proof-of-concept study - Improving teachers' and students' knowledge, skills and attitudes

Child sexual abuse (CSA) is a difficult form of abuse to detect, with the peak age of reports from 13 to 15 years old. The recent revision of the Philippine school curriculum provided an opportunity to incorporate an educational intervention for prevention of CSA. This study aimed to improve the teachers' and students' knowledge, skills and attitudes on disclosure, identification, and reporting of CSA. This research is a two-phase proof-of-concept cross-sectional study of 237 teachers and 1,458 Grade 7 students from 2 public high schools in metro Manila over a two-year period. Phase 1 involved in-service training curriculum for all teachers on the recognizing, recording, reporting, and referral (4R's) of child abuse and establishment of a referral and support system. Outcome measures included pre- and post-tests and number of CSA reports. Phase 2 involved implementation of eight student modules through the Health and Values Education subjects of the curriculum. Outcome measures were pre- and post-intervention measurement of abuse and module content. Training of teachers resulted in an increase in confidence for identifying CSA from 25% to 57%, and a decrease in apprehension of reporting CSA from 40% to 33%. The Safe Schools for Teens intervention significantly improved self-reported knowledge on abuse, dating violence, and how to help friends as well as on adolescent's impulse control and emotional clarity. There was a significant decline from pre- to post-intervention in self-reported experiences of dating violence which includes physical, sexual and emotional violence, t(793) = 3.363, p = 001 as well as a significant decline in self-reported experiences of emotional abuse from a dating partner, t(837) = 2.693, p = 0.008. The Safe Schools for Teens intervention increases awareness and reporting of child sexual abuse. The intervention also reduces dating violence highlighting that the mindfulness focused approach in connection with systems strengthening is useful for addressing adolescent violence.

The Associations between Family-Related Factors and Excessive Internet Use in Adolescents

This study examined the relationship between Excessive Internet Use (EIU) in adolescents and their family environment, namely the family type, the family economic status, the effect of parental care, the level of parental control, the amount of parental monitoring, the quality of communication, and the time spent together. The study was based on data from an international survey, Health Behaviour in School Aged Children (HBSC), conducted in Slovakia. The sample representative for adolescents included 2547 participants (51% boys) aged 13–15. Multiple-step linear regression revealed that higher parental care and parental monitoring predicted lower EIU, while higher parental overprotection and lower socioeconomic status predicted higher EIU. The results suggest that both so-called optimal parenting (i.e., the balance of emotional warmth and protection) and the adolescent′s autonomy lower the risk of EIU. Family factors explained about 14% of the variance, which suggests that aside from personal, cognitive and affective factors, a close social environment also plays an important role in adolescence EIU.

Regulation of NMDA Receptor Plasticity in the BNST Following Adolescent Alcohol Exposure

Persistent alterations in synaptic plasticity and neurotransmission are thought to underlie the heightened risk of adolescent-onset drinkers to develop alcohol use disorders in adulthood. The bed nucleus of the stria terminalis (BNST) is a compelling region to study the consequences of early alcohol, as it is innervated by cortical structures which undergo continued maturation during adolescence and is critically involved in stress and negative affect-associated relapse. In adult mice, chronic ethanol induces long-term changes in GluN2B-containing NMDA receptors (NMDARs) of the BNST. It remains unclear, however, whether the adolescent BNST is susceptible to such persistent alcohol-induced modifications and, if so, whether they are preserved into adulthood. We therefore examined the short- and long-term consequences of adolescent intermittent ethanol exposure (AIE) on NMDAR transmission and plasticity in the BNST of male and female mice. Whole-cell voltage clamp recordings revealed greater glutamatergic tone in the BNST of AIE-treated males and females relative to air-controls. This change, which corresponded to an increase in presynaptic glutamate release, resulted in altered postsynaptic NMDAR metaplasticity and enhanced GluN2B transmission in males but not females. Only AIE-treated males displayed upregulated GluN2B expression (determined by western blot analysis). While these changes did not persist into adulthood under basal conditions, exposing adult males (but not females) to acute restraint stress reinstated AIE-induced alterations in NMDAR metaplasticity and GluN2B function. These data demonstrate that adolescent alcohol exposure specifically modifies NMDARs in the male BNST, that the plastic changes to NMDARs are long-lasting, and that they can be engaged by stress.

Earlier Alcohol Use and Lower Neuropsychological Performance in Brazilian Adolescence: Is the School Environment Related to This?

OBJECTIVES

The aim of this study was to evaluate impulsivity, inhibitory control, and alcohol use in preadolescents and adolescents aged 10 to 16 from public and private schools.

METHODS

Participants were 190 adolescents selected from public and private schools in Brazil. Neuropsychological measures related to impulsivity (i.e., Barratt Impulsiveness Scale), inhibitory control (i.e., Go/No-go Task), and processing speed (i.e., Five Digits Test) were assessed.

RESULTS

60% of the sample had started drinking alcohol. Early alcohol consumption is not influenced by type of school, indicating that adolescents consume alcohol early, regardless of the type of education or income. Although there were significant differences in neuropsychological performance between types of schools, better neuropsychological performance was found in students from private schools.

CONCLUSIONS

When comparing consumption of alcohol among public and private school students, there were no significant differences, perhaps because the use of early alcohol can be a public health problem. Private school students may perform better in inhibitory control task because they have a good school environment, which serves as a protective factor.

Effects of exposure to polychlorinated biphenyls during different periods of development on ethanol consumption by male and female rats

In two experiments, male and female Sprague-Dawley rats were exposed to Polychlorinated Biphenyls (PCBs) to assess the effect PCBs, an estrogenic endocrine disrupting chemical (EEDC), would have on the voluntary consumption of alcohol. There are several EEDCs in our food that are known to increase estrogen in adolescent females. Our objective was to assess the effect that increasing estrogen, by adding the EEDC PCBs would have on volitional intake of alcohol. In Experiment 1, pregnant dams were exposed from gestational days 5-19 to a 1:1 mixture of Aroclor 1254/1260. In Experiment 2, lactating females were exposed to the same dose of 1254:1260 from postnatal days 1-21. In both experiments, a fade-in procedure was used to gradually introduce the rats to the taste of alcohol. At the end of the fade-in series all animals were given limited access (1 h/day) to a water/alcohol solution. We found that females exposed to PCBs, at two developmental periods, consumed significantly more alcohol than unexposed females and exposed and unexposed males. Results of the experiments are discussed in terms of how PCB exposure can disrupt endocrine processes (e.g., estrogenic endocrine disrupting chemicals, EEDC) that increase estrogen in females, thereby leading to increased alcohol consumption. Thus, the present findings suggest that EEDCs, such as PCBs, could contribute to the increase abuse of alcohol in adolescent females.

Maternal care-related differences in males and females rats' sensitivity to ethanol and the associations between the GABAergic system and steroids in males

This study investigated the effect of maternal care on adolescent ethanol consumption, sensitivity to ethanol-induced hypnosis, as well as gonadal hormones and γ-aminobutyric acid type-A (GABA_A ) systems. Long Evans rat dams were categorized by maternal licking/grooming (LG) frequency into High- and Low-LG mothers. Both female and male offspring from Low-LG rats demonstrated a greater sensitivity to ethanol-induced hypnosis in the loss-of-righting-reflex test at ethanol doses of 3.0 and 3.5 g/kg during late-adolescence (postnatal Day 50) but not at mid-adolescence (postnatal Day 42). However, we found no effect of maternal care on consumption of a 5% ethanol solution in a two-bottle choice test. We further investigated the association between the observed variations in sensitivity to ethanol-induced hypnosis and baseline hormonal levels in males. In male offspring from Low-LG mothers compared to High-LG mothers, baseline plasma corticosterone and progesterone levels were higher. GABA_A α1 and δ subunit expressions were also higher in the cerebral cortex of Low-LG males but lower in the cerebellar synaptosomal fraction. Early environmental influences on adolescent sensitivity to ethanol-induced hypnosis, consumption, and preference may be mediated by gonadal hormones and possibly through GABAergic functions.

Effects of Binge Drinking on the Developing Brain

Binge drinking is a pattern of alcohol drinking that raises a person's blood alcohol concentration to at least .08%, which amounts to consuming five alcoholic drinks for men and four alcoholic drinks for women in about 2 hours. It is the most common form of alcohol misuse in adolescents and young adults. Heavy drinking includes the same criterion as binge drinking, but with higher frequency (i.e., 5 or more days in the past 30 days). Although binge drinking or heavy drinking alone is insufficient to meet the criteria for an alcohol use disorder (AUD) diagnosis, there are neurobiological changes, as well as an increased risk of developing an AUD later in life, associated with this form of alcohol misuse. This review describes the recent neuroimaging findings in binge drinking and heavy-drinking adolescents and young adults, a developmental period during which significant neuromaturation occurs.

Impact of the Innate Immune Response in the Actions of Ethanol on the Central Nervous System

The innate immune response in the central nervous system (CNS) participates in both synaptic plasticity and neural damage. Emerging evidence from human and animal studies supports the role of the neuroimmune system response in many actions of ethanol (EtOH) on the CNS. Research studies have shown that alcohol stimulates brain immune cells, microglia, and astrocytes, by activating innate immune receptors Toll-like receptors (TLRs) and NOD-like receptors (inflammasome NLRs) triggering signaling pathways, which culminate in the production of pro-inflammatory cytokines and chemokines that lead to neuroinflammation. This review focuses on evidence that indicates the participation of TLRs and the inflammasome NLRs signaling response in many effects of EtOH on the CNS, such as neuroinflammation associated with brain damage, cognitive and behavioral dysfunction, and adolescent brain development alterations. It also reviews findings that indicate the role of TLR4-dependent signaling immune molecules in alcohol consumption, reward, and addiction. The research data suggest that overactivation of TLR4 or NLRs increases pro-inflammatory cytokines and mediators to cause neural damage in the cerebral cortex and hippocampus, while modest TLR4 activation, along with the generation of certain cytokines and chemokines in specific brain areas (e.g., amygdala, ventral tegmental area), modulate neurotransmission, alcohol drinking, and alcohol rewards. Elimination of TLR4 and NLRP3 abolishes many neuroimmune effects of EtOH. Despite much progress being made in this area, there are some research gaps and unanswered questions that this review discusses. Finally, potential therapies that target neuroimmune pathways to treat neuropathological and behavioral consequences of alcohol abuse are also evaluated.

Nucleus accumbens response to rewards and testosterone levels are related to alcohol use in adolescents and young adults

During adolescence there is a normative increase in risk-taking behavior, which is reflected in, for example, increases in alcohol consumption. Prior research has demonstrated a link between testosterone and alcohol consumption, and between testosterone and neural responses to rewards. Yet, no study to date tested how testosterone levels and neural responses to rewards relate to and predict individual differences in alcohol use. The current study aimed to investigate this by assessing alcohol use, testosterone levels and neural responses to rewards in adolescents (12–17 years old) and young adults (18–26 years old). Participants were measured twice with a two-year interval between testing sessions. Cross-sectional analysis showed that at the second time point higher neural activity to rewards, but not testosterone levels, explained significant variance above age in reported alcohol use. Predictive analyses showed that, higher testosterone level at the first time point, but not neural activity to rewards at the first time point, was predictive of more alcohol use at the second time point. These results suggest that neural responses to rewards are correlated with current alcohol consumption, and that testosterone level is predictive of future alcohol consumption. These results are interpreted in the context of trajectory models of adolescent development.

Longitudinal changes in adolescent risk-taking: a comprehensive study of neural responses to rewards, pubertal development, and risk-taking behavior

Prior studies have highlighted adolescence as a period of increased risk-taking, which is postulated to result from an overactive reward system in the brain. Longitudinal studies are pivotal for testing these brain-behavior relations because individual slopes are more sensitive for detecting change. The aim of the current study was twofold: (1) to test patterns of age-related change (i.e., linear, quadratic, and cubic) in activity in the nucleus accumbens, a key reward region in the brain, in relation to change in puberty (self-report and testosterone levels), laboratory risk-taking and self-reported risk-taking tendency; and (2) to test whether individual differences in pubertal development and risk-taking behavior were contributors to longitudinal change in nucleus accumbens activity. We included 299 human participants at the first time point and 254 participants at the second time point, ranging between ages 8-27 years, time points were separated by a 2 year interval. Neural responses to rewards, pubertal development (self-report and testosterone levels), laboratory risk-taking (balloon analog risk task; BART), and self-reported risk-taking tendency (Behavior Inhibition System/Behavior Activation System questionnaire) were collected at both time points. The longitudinal analyses confirmed the quadratic age pattern for nucleus accumbens activity to rewards (peaking in adolescence), and the same quadratic pattern was found for laboratory risk-taking (BART). Nucleus accumbens activity change was further related to change in testosterone and self-reported reward-sensitivity (BAS Drive). Thus, this longitudinal analysis provides new insight in risk-taking and reward sensitivity in adolescence: (1) confirming an adolescent peak in nucleus accumbens activity, and (2) underlining a critical role for pubertal hormones and individual differences in risk-taking tendency.

Coping and Social Support in Children Exposed to Mass Trauma

The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well.

Effects of genetic variants of ADH1B and ALDH2 and social network on continued alcohol drinking among young adolescents in Taiwan

BACKGROUND

This study aimed (i) to evaluate the effects of genetic variants of ADH1B and ALDH2 and social network position on continued alcohol use in early adolescence, and (ii) to explore possible moderating role of pubertal development on genetic effects.

METHODS

The sample comprised 496 children who ever drank alcohol before the ages of 10-12. Information pertaining to sociodemographic background, pubertal development, parental drinking, alcohol and tobacco use, alcohol-metabolizing genes, and nominated best friends was collected in four waves of assessment. Polymorphisms of ADH1B (rs1229984) and ALDH2 (rs671) were genotyped. The latent class analysis was first used to characterize longitudinal alcohol use pattern, followed by the multinomial logistic regression analyses to assess its association with genes, pubertal development, and social network.

RESULTS

Three distinct classes of alcohol users (i.e. ex-drinkers, sporadic drinkers, and continued drinkers) were derived from alcohol-experienced children. Both alcohol-metabolizing genes appear to have protective effects, yet such relationships were only significant for youngsters in pre-to-early pubertal stage: the adjusted odds ratio (aOR) of ADH1B fast-genotype for sporadic drinkers was 0.46 and that of ALDH2 slow-genotype for both sporadic and continued drinkers was 0.47 and 0.42, respectively. Children having the bridge position in their peer network were more likely to be sporadic drinkers (aOR=4.15) and continued drinkers (aOR=3.16).

CONCLUSIONS

Our results illustrate a potential moderating effect of pubertal development on the protective influence of alcohol-metabolizing genes on subsequent alcohol use among alcohol-experienced children as well as the independent contribution of early life's social network to their alcohol involvement.

The adolescent origins of substance use disorders: a behavioral genetic perspective

Over the past twenty years there has been an increasing recognition within the substance abuse research field that substance use disorders (SUDs) are usefully conceptualized within a developmental framework. That is, initiation of substance use in adolescence and escalation to substance abuse in early adulthood are strongly age-graded, with the relevant behavioral risk and protective factors manifesting early in development, often prior to substance use onset. In this chapter we review a program of research that seeks to provide a behavioral genetic perspective on the development of SUDs. The Minnesota Center for Twin and Family Research (MCTFR) undertakes longitudinal research on families including twins, adopted siblings and non-adopted siblings spanning early adolescence through early adulthood. A total of nearly 10,000 individuals in 2500 families have participated in MCTFR research. We review findings from the MCTFR to establish four general features of the development of SUDs informed by behavioral genetic research: 1) Both general and specific processes contribute to the aggregation of SUDs in families; 2) genetic contributions to SUD risk appear to be primarily at the general factor level, although the contribution of the general factor appears to decrease with age; 3) SUD risk is manifested before initiation of substance use in terms of elevated levels of externalizing psychopathology and personality characteristics indicative of low self-control; and 4) the genetic factors that contribute to SUD risk appear to be numerous with very small phenotypic effects, making them difficult to identify.

The Teenage Brain: Self Control

Adolescence refers to the transition from childhood to adulthood that begins with the onset of puberty and ends with successful independence from the parent. A paradox for human adolescence is why, during a time when the individual is probably faster, stronger, of higher reasoning capacity and more resistant to disease, there is such an increase in mortality relative to childhood. These untimely deaths are not due to disease, but rather to preventable forms of death (accidental fatalities, suicide and homicide) associated with adolescents putting themselves in harm's way due, in part, to diminished self control - the ability to suppress inappropriate emotions, desires and actions. This paper highlights how self control varies as a function of age, context and the individual and delineates its neurobiological basis.